MedicaidAdministrativeMedium impact
AHCCCS DFSM Claims Clues - October 2018
Arizona Medicaid - AHCCCS·AZ · Emergency Medicine, Psychiatry·Claims & Billing
Effective date
Oct 1, 2018
We identified it
Jun 17, 2026
Summary
AHCCCS has updated billing requirements for crisis services, clarified RBHA responsibility changes effective October 1, 2018, and implemented mandatory ICD indicator requirements for claim forms. Claims without proper ICD indicators will be returned for correction.
Action Required
Immediately: Update billing procedures to include mandatory ICD indicator in field 21 of CMS 1500 forms and field 66 of UB-04 forms (enter '0' for ICD-10-CM). Billing team must ensure crisis services codes H2011, S9484, S9485, H0031, H0038, 90791, T1002, T1016 are billed to correct entity (RBHA vs ACC/AIHP) based on population and setting. Update RBHA names in billing system: North becomes Steward Health Choice Arizona, Central becomes Mercy Care, South becomes Arizona Complete Health. Claims missing ICD indicators will be returned unprocessed.